Intra-aortic balloon counterpulsation as a bridge to heart transplantation does not impair long-term survival
| Autor: | Einar Gude, Svein Simonsen, Ola Gjesdal, Harald Brunvand, Thor Edvardsen, Odd Geiran, Arne K. Andreassen, Lars Gullestad, Satish Arora, Lars Aaberge, Torbjørn Leivestad |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Aspartate transaminase Hemodynamics chemistry.chemical_compound Counterpulsation Internal medicine medicine Humans Aspartate Aminotransferases Postoperative Period Retrospective Studies Intra-aortic balloon pump Heart Failure Heart transplantation Analysis of Variance Creatinine Intra-Aortic Balloon Pumping biology Norway business.industry Retrospective cohort study Middle Aged medicine.disease Survival Analysis Transplantation chemistry Case-Control Studies Heart failure Cardiology biology.protein Heart Transplantation Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Heart Failure. 11:709-714 |
| ISSN: | 1388-9842 |
| Popis: | Aims There are few studies of the use of intra-aortic balloon pump (IABP) treatment as a bridge to heart transplantation (HTx). This is the first study to compare long-term clinical and haemodynamic outcomes in IABP-treated HTx patients and electively transplanted patients. Methods and results This was a retrospective study of all adult HTx recipients between 2001 and 2007. Thirty-two patients (aged 50 ± 13 years) treated with IABP, as a bridge to HTx due to severe hypo-perfusion, were compared with 135 electively transplanted patients (aged 54 ± 11 years). The mean time from onset of IABP to HTx was 21 ± 16 days. Clinical condition improved during IABP treatment. Serum creatinine decreased from 128 ± 56 to 102 ± 29 µmol/L (P < 0.01), aspartate transaminase from 682 ± 1299 to 63 ± 89 U/L (P = 0.01), and ALAT from 483 ± 867 to 126 ± 284 U/L (P = 0.02). Intra-aortic balloon pump treatment related complications were few. Mortality was similar in the IABP and control groups at 30 days post-HTx (6.2 vs.3.7%, P = 0.54), at 1 year (9.4 vs.11.1%, P = 0.80), and beyond. Long-term clinical and haemodynamic indices were similar in the two groups. Conclusion Intra-aortic balloon pump treatment stabilizes patients in end-stage heart failure, is safe, well tolerated, and is successful in bridging acutely decompensated patients to transplantation. Complications are few and manageable. Following IABP and HTx, short- and long-term survival, biochemical and invasive and non-invasive haemodynamic outcomes were similar to those in electively transplanted patients. |
| Databáze: | OpenAIRE |
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